心脏死亡供者供肝肝移植11例疗效观察
发表时间:2014-06-11 浏览次数:1284次
吕国悦,邱伟,王海峰等.心脏死亡供者供肝肝移植11例疗效观察[J].中华普通外科杂志.2013.28(3):186-188
肝移植,供者选择,心脏死亡
吕国悦,邱伟,王海峰,杜晓宏,孙晓东,刘松阳,王刚,王广义
13OO21长春,吉林大学白求恩第一医院肝胆胰外科
2013
186-188
知网,万方
目的:观察利用Maastricht分类第Ⅲ型心脏死亡供者(donors after cardiac death,DCD)供肝行原位肝移植的疗效。 方法 2011年 9月 至2012年 6月 期间,吉林大学白求恩第一医院共有14例 DCD供者进行器官捐献,其中 11例行原位肝移植,分析总结心脏死亡供肝行肝移植的疗效。结果 本组 11例 DCD供肝热缺血时间为(21.3±2.6)min,冷缺血时间为(2.5±0.8)h,供肝质量为(1245± 180)g。 11例受体行原位肝移植术,术中无肝期42~80min,手术时间380~740 min,术中出血量600~3000ml,平 均1750ml。 除I例受体于术后第3天死于原发移植肝无功能外,其余受体术后均恢复良好。在全程随访期间预后较好,均未出现排斥反应及胆管、 血管并发症。 结论 通过规范捐献流程、 尽量减少冷、 热缺血时间及加强器官功能维护,利用Maastricht分类第Ⅲ型心脏死亡供者供肝对终末期肝脏疾病患者行肝移植,疗效良好。 Objective To evaluate the effect of liver transplantation using Maastricht Ⅲ DCD donor 1iver on clinical results. Method From September 2011 to June 2012, We had 14 cases of controlled cardiac death donors, of Which 11 donor grafts were used for in situ liver transplantation, we eva1uate these 11 in situ liver transp1antations cases by data analysis Results The warm ischemia time was(2.5±2.6)min,and cold ischemia time was(2.5±0.8)h,the mass of donor hver was(1245±180)g. The anhepatic phase was42-80min,the length of operation was380-740min Blood loss was 600-3000ml, averaging1750ml one recipient died of primary liver graft non~function on the3rd day after surgery , 10 patients recovered well. The prognosis was s good in the entire follow~up period, and there were no bile duct and vascular complications Conclusions. The result of end-stage liver discase patients receiving Maastricht Ⅲ DCD donor liver graft in situ liver transplantation is satisfactory.